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. 2023 Oct 18;13:17739. doi: 10.1038/s41598-023-44389-9

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© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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(a) Sankey diagram depicting treatment sequencing among patients with rheumatoid arthritis initiating a b/tsDMARD who transition to a second-line, and/or third-line treatment (N = 31,232). b/tsDMARD biologic target synthetic disease modifying antirheumatic drug; tsDMARD limited to tofacitiniv at time of analysis; Sankey diagram limited to b/tsDMARDs. csDMARDs, conventional disease modifying antirheumatics, not shown and may be combination with b/tsDMARDs). (b) Sankey diagram of patients with rheumatoid arthritics initiating a b/tsDMARD who transition to a second-line, or third-line treatment (SUS-exclusive cohort) in DATASUS (N = 18,042). b/tsDMARD biologic target synthetic disease modifying antirheumatic. tsDMARD limited to tofacitinib at time of analysis;Sankey limited to b/tsDMARDs (csDMARD, conventional disease modifying antirheumatics, not shown and may be combination with b/tsDMARDs); SUS-exclusive are individuals, dependent on SUS for all healthcare resources. (c) Sankey diagram of patients with rheumatoid arthritis initiating a b/tsDMARD who transition to a second-line and/or third-line treatment (SUS+ private insurance cohort)in DATASUS (N = 13,190). b/tsDMARD biologic target synthetic disease modifying antirheumatic. tsDMARD limited to tofacitinib at time of analysis. Sankey limited to b/tsDMARDs (csDMARDs, conventional disease modifying antirheumatics, not shown and may be combination with b/tsDMARDs). SUS+ private insurance are individuals dependent on SUS only for prescription drug coverage.